Gibson Canyon WTP Tracer Study Results
A tracer study was conducted at the Gibson Canyon Water Treatment Plant to determine disinfection contact time and baffling factor for the clearwell tank. The study analyzed the tracer material, injection method, and field results to assess water treatment efficiency and safety. Key parameters such as t10 value, HRT, and baffle design were examined to optimize the water treatment process.
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New Horizons in Medical Education November 20 - 21, 2015 Weill Cornell Medicine - Qatar
Accreditation This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Weill Cornell Medical College and Weill Cornell Medical College in Qatar. Weill Cornell Medical College is accredited by the ACCME to provide continuing medical education for physicians. Weill Cornell Medical College designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credit(s) . Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Identifying and Helping the Struggling Learner G Dodd Denton, MD MPH Stephanie Call, MD
Disclosures We have no Conflicts of Interest to disclose
Agenda Discuss Uses of Evaluation Framework to identify a struggling learner Domain-based Developmental Synthetic Discuss coaching as a method of remediation
Let me tell you about a student SC started her third year in July on the internal medicine wards. Three weeks into the six-week rotation, my program support assistant informed me of her midpoint evaluation form: Her attending gave her marks of three (9- point scale) for five questions
What did the form show? Low marks (3/9): Clinical Skills (including physical exam) Professionalism Interpersonal Skills Taking Feedback Good marks (7-8/9): Medical knowledge, system-based practice, potential as a physician Overall mark was 7/9: interpreter level
Interpreting the form The Bad: No comments Domains open to interpretation Actual behavior not described. Difficulty classifying the dysfunction The Good Teaches faculty what to observe Ease of use Consistency; ability to analyze
Analytic Evaluation Framework knowledge skills attitudes/behavior KSA
Tell me about SC She s terrible and I want to fail her right now
What did you observe? Probably the best question you can ask an evaluator Detailed description of an observed encounter helps classify the learner s problem If the teacher doesn t know educational terminology, you can classify the problem
Using analytic to encompass a complex task Working on a ward team Writing Notes Not knowing PE Resistant to Feedback Skills Knowledge.. Attitude ..
Developmental Framework Novice Advanced beginner students Competent performance residents Proficient performance Intuitive expert us Master Mind Over Machine (1986)
Developmental vs. Analytic time-line, not static, becoming is included; independence is approached progressively higher function (apprentice model) Terms can be confusing what is a novice at professionalism? In choosing an antihypertensive?
Developmental Terms: Novice Can perform a basic physical exam Advanced learner Skilled physical examination Expert Integrates psychosocial issues into physical exam
Really need more data Called the resident on the team Problems were more extensive overtalked the resident Overly confident in knowledge Fellow students didn t like her Called her into the office
ACGME Competencies Medical Knowledge Patient Care Interpersonal skills Professionalism Practice-based learning and Improvement System-based Practice
Professionalism Knowledge SBP Patient Care PBLI Communication Skills
Cutting through the complexity reliable valid feasible low tech is good tech whose time will be spent?
How about a different Framework Synthetic Developmental Domain-based Behaviorial Where you can visualize progress
The RIM/E Framework Reporter Interpreter Manager-Educator
Reporter Answers What questions Accurately, reliably assesses and communicates Complete, Honest Takes: knowledge, responsibility, hard- work, trust
Interpreter Answers Why questions Prioritizes, analyzes, synthesizes Reasonable, not right (student) Takes: more knowledge, confidence, greater independence What do you think?
Manager Answers the How questions Proposes actions and options applied to individual patient Has maturity, skill and knowledge to negotiate with patients on plans Takes: Knowledge, Maturity, Outward Focus, Reflection
Educator Poses questions, independently seeks answers Shares new knowledge, teaches others, becomes a leader Takes: insight, confidence, knowledge, skill
The Rhythm of RIME SOAP Symptoms ( Subjective ) Observations ( Objective ) Reporter Observation Interpreter Assessment Reflection Manager Action Plan Educator
Back to SC My assistant made an appointment for her. She showed up 30 minutes late, wearing shorts and a tank top. I asked her how she thought she was doing
The New Feedback Sandwich* Ask Tell Ask
Ask Ask learner to assess own performance first What went well and what could have gone better? What were their goals? Have they ever seen a patient like this before? Begins a conversation Assesses learner s level of insight Useful for second-hand feedback
Tell Tell what you observed: diagnosis and explanation React to the learner s observation Feedback on self-assessment Include both positive and corrective elements I observed . Give reasons in the context of well-defined shared goals
Ask (again) Ask about recipients understanding and strategies for improvement What could you do differently? Give own suggestions Perhaps even replay parts of the encounter: show me Commit to monitoring improvement together
